We have recently encountered a case of Kasabach-Merritt syndrome which was characterized by hemangioma, thrombocytopenia, and Disseminated Intravascular Coagulation. The baby was delivered at 35 weeks gestation. A large hemangioma covered right forearm. He received interferon alfa-2a for 120 days after 20 day steroid treatment failure. Blood platelet count increased to acceptable range (>20,000/mm3) after 8weeks of interferon alfa-2alpha treatment and the size of hemangioma decreased.
Disseminated Intravascular Coagulation ; Forearm ; Hemangioma ; Interferons* ; Kasabach-Merritt Syndrome* ; Platelet Count ; Pregnancy ; Thrombocytopenia ; Treatment Failure

PURPOSE: Intussusception in adults is uncommon and constitutes approximately 5% of all intussusceptions. An organic lesion is found to be the lead point in 75 to 90% of the cases, so surgical intervention is necessary in most cases. This study was designed to review our experience with adult intussusception and to determine an appropriate method for diagnosis and management. METHODS: Thirteen (13) patients over 15 years of age were diagnosed as having on intussusception at our center between 1994 and 2003. We reviewed the medical records of these patients retrospectively. RESULTS: The preoperative diagnosis had been made correctly in 85% of patients (11 cases) by combined use of abdominal ultrasonography and a CT scan. The types of intussusceptions wene jejuno-jejunal in two cases, ileo-ileal in four, ileo-colic in three, and colo-colic in four. Causative organic lesion was found in all patients; seven cases (54%) were due to benign tumors, and six (46%) were due to malignant tumors. Surgical intervention was carried out in all cases; 11 patients underwent a surgical resection without manual reduction, and 2 patients underwent a surgical resection after manual reduction. CONCLUSIONS: Both abdominal ultrasonography and CT scan are effective and useful diagnostic tools in the diagnosis of adult intussusception. Since tumors, benign or malignant, are the most frequent cause of adult intussusception, surgical intervention is mandatory.
Adult* ; Diagnosis ; Humans ; Intussusception* ; Medical Records ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

No abstract available.
Lupus Erythematosus, Systemic*

Koreans had an ill feeling against the only public isolation hospital, and their ill feeling was a cause the movement for establishing a private isolation hospital. The bad seating capacity and the nearness to downtown of public isolation hospital, and some violence caused in the course of taking a patient to the public isolation hospital were concrete causes of the movement for establishing a private isolation hospital. The three purposes of the movement for establishing a private isolation hospital are as follows. First, for the purpose of removing the national ill feeling, Koreans had to establish the isolation hospital by themselves. Second, for the purpose of curing the patients, doctors needed to use Oriental medicine together. Third, for the purpose of doing away with the anxiety of infection, the isolation hospital had to be located in a distant place from downtown. The movement for establishing a private isolation hospital didn't succeed. It only ended up establishing a contagious ward in Severance hospital. Because whenever an isolation hospital was planned to be constructed somehere, the residents worrying about the infection opposed to the construction, and enough money didn't be gathered. Abve all, rich pro-Japanese men didn't contribute enough money. The middle and lower classes contributed almost all of the money. The movement for estabishing a private isolation hospital was the extension of anti-Japanese national feeling that sprung from the March 1st movement. In view of strenghtening Korean ability, the movement for establishing a private isolation hospital had a common cause with the Shilryokyangsong movement in the early 1920s.
Cholera/*history ; Colonialism/*history ; Communicable Diseases/*history ; English Abstract ; History of Medicine, 20th Cent. ; Hospitals, Public/*history ; Hospitals, Special/*history ; Human ; Japan ; Korea ; Patient Isolation/*history ; Politics

In the review of a series of 71 clavicle shaft fracture that were treated with open reduction and internal fixation, we tried a direct comparison between two fixation modes, that is, the fixation with plate and screws (54 cases) and the intramedullary nailing with Knowles pin (17 cases). The average time to healing was not significantly different between the two group; 10.8 weeks after the plating and 11.7 weeks with Knowles pinning. The rate of successful healing within four months after the surgery were also high in both groups: one delayed union and one nonunion in the plate group, and one delayed union in the Knowles pin group. There was one loosening in the Knowles pin group, which needed reoperation. Intramedullary fixation has several advantages compared with fixation with a plate and screws. It can be performed through a shorter incision: less dissection of soft tissue is needed: and, after healing, the pin is easily removed through a small incision under local anesthesia.
Anesthesia, Local ; Clavicle ; Fracture Fixation, Intramedullary ; Reoperation

OBJECTIVE: To compare the effects of intermittent mechanical traction with spinal decompression therapy (SDT), using the newly introduced device DRX 3000(R), in patients suffering from low back pain associated with lumbosacral disc herniation documented on MRI. METHOD: Thirty-five patients with low back pain with or without lower extremity radiating pain were prospectively enrolled in this study. They were all diagnosed with lumbosacral disc herniation according to physical examinations and MRI. Patients over age 60 years or those with previous spinal surgery, spondylolisthesis, severe osteoporosis, rheumatic diseases, hypertension, and other serious medical problems were excluded. Patients were randomly assigned to intermittent mechanical traction group (15 patients) or SDT group (20 patients) and compared visual analog pain scale (VAS) pre- and post-treatment. RESULTS: There was a significant improvement in VAS in SDT group compared to intermittent mechanical traction group. The mean reduction in VAS for intermittent mechanical traction group equaled 1.93+/-0.83 (from 6.4+/-1.28 to 4.5+/-1.22) while the mean reduction in VAS in SDT group equaled 4.35+/-2.21 (from 6.9+/-1.86 to 2.6+/-1.43) (p=0.0006). CONCLUSION: Spinal decompression therapy can be used as an effective treatment for discogenic low back pain without serious complications.
Decompression ; Humans ; Hypertension ; Low Back Pain ; Lower Extremity ; Osteoporosis ; Pain Measurement ; Physical Examination ; Prospective Studies ; Rheumatic Diseases ; Spondylolisthesis ; Stress, Psychological ; Traction

Many Oriental women have prominent mandibular angle and short chin, in other words, 'squared' mandibular face or 'boxy' face. That kind of face is considered to be unattractive and causes big cosmetic problems for those who want to have an ovoid or almond shaped face. A squared mandibular face often needs to be corrected by operative procedure. A reduction mandibular angleplasty by bony angle resection is one of the operative procedures, but it is not always an adequate method. The successful correction of squared mandibular face can be accomplished by horizontal facial reduction and/or vertical facial lengthening procedure. From March 1996 to March 2000, We had operated 117 patients. The patients were divided into 3 groups. Group I had prominent mandibular angle and/or massetric hypertrophy. Patients in this group were operated by reduction angleplasty with/without resection of masseter muscle. Group II had prominent mandibular angle, cheek and mandibular body. In this case, we applied reduction angleplasty, contouring of body, resection of buccal fat pad and/or masseter muscle. Group III had prominent mandibular angle with short face. We used methods used for group II and Le Fort I lengthening and genioplasty. Ancillary procedures were forehead lengthening and reduction maloplasty. Successful correction of squared mandibular face could be performed by accurate analysis of facial profile and reduction mandibular angleplasty with proper ancillary procedures for each group. The results were as follows: 1) We obtained successful correction of squared mandibular face with multiple horizontal facial reduction procedures, which reduced anterior and posterior facial plane. 2) In case of short face, we made better mid-low facial balance with vertical facial lengthening and horizontal facial reduction.
Adipose Tissue ; Cheek ; Chin ; Female ; Forehead ; Genioplasty ; Humans ; Hypertrophy ; Masseter Muscle ; Prunus dulcis ; Surgical Procedures, Operative

OBJECTIVE: Stroke is a major cause of mortality throughout the world and several studies have reported survival experience following stroke in different populations. This study estimates the prevalence of behavioral risk factor after stroke and explores lifestyle changes. METHOD: The subjects were 529 patients, who were admitted at the Kyung Hee Medical Center from January 2000 to February 2001. Data collection was done through chart reviews, telephone interviews, and mail. Main measures included smoking status, alcohol use, and obesity. Chisquare test and multiple logistic regression were used to determine sociodemographic differences in these measures. RESULTS: At 1 year after stroke, 11.2% of patients still smoked, 31.4% of patients were obese, and 13% drank excessively. Younger patients and patients with high blood pressure were more likely to smoke. Younger patients were more likely to drink excessively. Women, patients with diabetes, and those living in the metropolitan areas were more likely to be obese. CONCLUSION: Different behavioral risk factors were associated with specific sociodemographic groups within the stroke population. After stroke, high-risk groups should continue to be targeted to prevent stroke recurrence.
Data Collection ; Female ; Humans ; Hypertension ; Interviews as Topic ; Life Style* ; Logistic Models ; Mortality ; Obesity ; Postal Service ; Prevalence* ; Recurrence ; Risk Factors* ; Smoke ; Smoking ; Stroke*

OBJECTIVE: To introduce the technique of the ultrasound-guided selective nerve root injection in the lower cervical spine and to evaluate its accuracy and distribution patterns of injections. METHOD: Thirty-one patients with the cervical radiculopathies (C5 to C7) from cervical disc herniation were enrolled in this study. Targeted nerve root image was obtained and the needle was introduced to its dorsal surface under the ultrasound guidance. Then 2 ml of contrast media was injected which was followed by fluoroscopic image. The accurate injection was defined as the contrast media placed over the neural foramen along the targeted nerve root. RESULTS: 24 of 31 (77.4%) procedures were assesed to be accurately placed and there was no significant complication. The accuracy of injection was lower at the C7 nerve root (70.0%) than other nerve roots. In all cases, large amount of back flow to the brachial plexus and spread to the adjacent nerve roots were observed. CONCLUSION: In the lower cervical spines, ultrasound-guided selective nerve root injections might be considered as a radiation free, safe and available method.
Brachial Plexus ; Contrast Media ; Equidae ; Humans ; Needles ; Radiculopathy ; Spine

OBJECTIVE: The purpose of this study was to observe the characteristics of the clinical improvement and the electrodiagnostic study in non-traumatic facial nerve palsy. METHOD: The clinical observation and the electrodiagnostic study were done in 57 of 266 patients who were treated at the Kyunghee Medical Center from December 2000 to July 2001. The initial study was done at 2 weeks from the onset time, and the follow-up study was done at 3 months later. The blink reflex, nerve conduction study and needle EMG were done, and made a statistical comparison between the initial and follow-up study. RESULTS: The clinical improvement and the change of the electrodiagnostic study between the initial and follow-up study were remarkable in the patients with expected to be good and fair prognosis. In the electrodiagnosis study, there were no statistical correlations on the % degeneration of the CMAP amplitude in the patients with expected to be poor prognosis. CONCLUSION: Although the ideal electrodiagnostic study does not yet exist, the best method of evaluating the facial nerve is side-to-side evoked amplitude comparison, and not only the initial study but also the follow-up, this method would be very useful.
Blinking ; Electrodiagnosis ; Facial Nerve* ; Follow-Up Studies ; Humans ; Needles ; Neural Conduction ; Paralysis* ; Prognosis